Abstract
We investigated the prospective associations of body composition with cardiac structure and function and explored effect modification by sex and whether inflammation was a mediator in these associations. Total body (BF), trunk (TF) and leg fat (LF), and total lean mass (LM) were measured at baseline by a whole body DXA scan. Inflammatory biomarkers and echocardiographic measures were determined both at baseline and follow-up in the Hoorn Study (n = 321). We performed linear regression analyses with body composition measures as determinant and left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) or left atrial volume index (LAVI) at follow-up as outcome. Additionally, we performed mediation analysis using inflammation at follow-up as mediator. The study population was 67.7 ± 5.2 years and 50% were female. After adjustment, BF, TF and LF, and LM were associated with LVMI with regression coefficients of 2.9 (0.8; 5.1)g/m2.7, 2.3 (0.6; 4.0)g/m2.7, 2.0 (0.04; 4.0)g/m2.7 and − 2.9 (− 5.1; − 0.7)g/m2.7. Body composition measures were not associated with LVEF or LAVI. These associations were not modified by sex or mediated by inflammation. Body composition could play a role in the pathophysiology of LV hypertrophy. Future research should focus on sex differences in regional adiposity in relation with diastolic dysfunction.
Highlights
We investigated the prospective associations of body composition with cardiac structure and function and explored effect modification by sex and whether inflammation was a mediator in these associations
Cross-sectional studies have shown that higher Body mass index (BMI), waist circumference, body and visceral fat, and lean body mass are associated with worsening of various echocardiographic measures related to cardiac structure and function such as left ventricular mass and left atrial volume[9,10,11,12,13,14]
Higher total body, trunk and leg fat at baseline were associated with higher left ventricular mass index (LVMI) after eight years of follow-up, and higher total lean mass was associated with lower LVMI at follow-up
Summary
We investigated the prospective associations of body composition with cardiac structure and function and explored effect modification by sex and whether inflammation was a mediator in these associations. Cross-sectional studies have shown that higher BMI, waist circumference, body and visceral fat, and lean body mass are associated with worsening of various echocardiographic measures related to cardiac structure and function such as left ventricular mass and left atrial volume[9,10,11,12,13,14]. These echocardiographic measures are among other measures, used as diagnostic criteria to detect HFpEF15. Though sex-specific results from cross-sectional studies on various body composition measures and levels of inflammatory biomarkers are inconsistent[18,19,20]
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